二甲双胍对多囊卵巢综合征患者生殖内分泌功能的影响

Effects of metformin on reproductive and endocrinic function in patients with polycystic ovarian syndrome

目的 评价二甲双胍对多囊卵巢综合征 (PCOS)患者的生殖内分泌功能的影响。 方法 32例 PCOS患者 ,采用二甲双胍 75 0 mg/d口服 ,连续 12周 ,治疗前后检测患者血 L H、FSH、T水平及卵巢体积 ,用药期间患者自己记录基础体温 (BBT) ,每 4周随访 1次 ,直至停药后 3个月 ,了解患者月经及妊娠情况。 结果 治疗后月经恢复正常者占 6 2 .5 0 % (2 0 /32 ) ,BBT双相者占37.5 0 % (12 /32 ) ,妊娠者占 2 5 .0 % (8/32 )。卵巢体积治疗前右侧为 (7.2 0± 1.2 3) cm3,左侧为(7.5 0± 1.17) cm3,治疗后 2 4例行卵巢体积测量右侧为 (6 .5 0± 0 .85 ) cm3,左侧为 (6 .6 0± 1.0 8) cm3,差异均有显著性 (P<0 .0 1,P<0 .0 5 )。血 T、 L H、 L H/FSH比值分别由治疗前的 (2 .36±1.4 6 ) nm ol/L,(10 .16± 3.78) U/L 和 (2 .72± 1.0 0 ) ,下降为治疗后的 (1.5 7± 1.2 1) nm ol/L 和(6 .97± 3.99) U/L,(1.86± 1.2 8) ,差异有显著性 (P<0 .0 1,P<0 .0 5 )。 结论 二甲双胍可以改善 PCOS患者的生殖内分泌异常及一些临床症状 ,是治疗 PCOS的一条安全、有效的新途径。

Objectives To evaluate the effects of metformin on reproductive and endocrinic function in patients with polycystic ovarian syndrome(PCOS). Methods 32 patients with PCOS were treated orally with metformin 750 mg daily for 12 weeks.The menstrual alteration,ovulation,gestation and the volume of ovary were observed.The serum concentration of testosterone(T),luteinizing hormone (LH) and luteinizing hormone /follicle stimulating hormone(LH/FSH) were measured before and after the treatments. Results The patients were observed 3 months after treatment.62.50 %(20/32) patients restored to the normal menstrual cycle.The basic body temperature(BBT) became biphase in 37.50 %(12/32) patients.And 25.00 %(8/32) patients were pregnant.The ovarian volume changed from right (7.20±1.23) cm 3,left (7.50±1.17) cm 3 to right (6.50±0.85) cm 3,left(6.60±1.08) cm 3.The volume of both side ovaries decreased significantly (P<0.05).After the treatment,T reduce from (2.36±1.46) nmol/L to (1.57±1.21) nmol/L;LH from (10.16±3.76) U/L to (6.97±3.99) U/L;LH/FSH ratio diminished from (2.72±1.10) to (1.86±1.28).The significant difference were observed(P<0.05). Conclusion Metformin could improve reproductive and endocrinic function in patients with PCOS and improve some other symptoms.It is a new,safety and efficient method in PCOS therapy.